Chapter 711: Chapter 291: Of the Two Evils, Choose the Lesser, We Still Need to Ask Zhou Can_3
After a detailed understanding of the patient’s situation, he realized that this case was far from as easy to diagnose as he had imagined.
It also made him realize that despite the Digestive Internal Medicine department having made great contributions in diagnosing difficult cases before, without Zhou Can, he, as an associate chief physician, was nothing.
"Dr. Zhou, here are the patient’s examination records, take a look first."
Deputy Director Shi seemed to have found a savior.
Other doctors witnessing this scene didn’t say anything, but when they looked at Deputy Director Shi and Zhou Can, there was a certain peculiarity in their gazes.
That pervasive Journalist Mu was also closely watching from not too far away.
Especially since Zhou Can had arrived, her gaze locked onto him like an eagle, not shifting away.
Seeing Deputy Director Shi handing over the patient’s examination records to Zhou Can, with a relieved expression as if a savior had arrived, she couldn’t help but curl her lips slightly.
"A resident stronger than an attending physician, I’ve really seen everything now!"
She muttered quietly, her interest in Zhou Can, the resident, growing even more.
Zhou Can took the examination records, and Director Zhang spoke to him in a timely manner, "Our current unanimous discussion opinion is to consider the patient’s rectal cancer to be caused by metastatic cancer. Abdominal effusion is the best proof."
Indeed, if rectal cancer were a primary lesion, it should not cause abdominal effusion.
"Did you examine the abdominal effusion? For example, whether there are cancer cells in it."
With modern medical technology being advanced, there are many ways to test.
In such cases, directly examining the components of the abdominal effusion also has a certain chance of identifying the primary lesion.
"We did! Here, this one. The result indicates that well-differentiated signet-ring cells were found in the abdominal effusion."
Director Zhang, after witnessing Zhou Can’s capabilities, no longer regarded him as a resident but elevated him directly to the level of an attending physician.
During the discussion, she answered Zhou Can’s questions directly.
This invisible reliance was enough to make Gao Jian and Du Leng present to feel incredibly jealous. Yang Chan, who was Zhou Can’s classmate, didn’t feel jealous but felt the competitive pressure.
She was determined to work even harder in the future, striving to catch up with Zhou Can.
Now, the gap between her and Zhou Can was huge.
This was something she could clearly feel and had come to recognize.
"Signet-ring cells, then we should check the stomach! We can consider the possibility of gastro-intestinal cancer metastasis."
Zhou Can had spent three months in Digestive Surgery, and it was not in vain.
He had a deep understanding of various digestive system cancers, familiar with them like the back of his hand.
Director Zhang’s eyes flashed with a hint of appreciation.
This young man really had some skills. Every step of his diagnosis was consistent with their collective discussion results.
You should know, this group of experts had also discussed for a long time before determining the great possibility of gastric metastasis. Yet Zhou Can pointed directly to the stomach effortlessly; this was true expertise!
"Gastrointestinal imaging shows a mass at the greater curvature of the stomach, and additional masses were found on the anterior wall of the rectum and the peritoneum."
Director Zhang continued.
Zhou Can reviewed the corresponding examination records.
"Her primary cancer lesion is very likely in the ovaries."
Not long ago, he had been involved with an ovarian cancer patient, and the impression of this disease was too profound.
Ovarian cancer is even more insidious and cunning than lymphoma, extremely difficult to diagnose.
They both share a common characteristic: the primary lesion does not reveal much in terms of symptoms, whereas the symptoms of the metastatic lesions are prominent. It’s like the strategy of "Obvious paths are for deception, secret operations are decisive" from the Thirty-Six Stratagems.
There’s also a bit of a feint to the east, attack in the west tactic.
This cancer is indeed as cunning as a wolf.
"But the patient had an abdominal CT at another hospital, and there were no obvious ovarian lesions!" said Director Zhang.
"Ovarian cancer is highly skilled in camouflage. There is a fastest way to confirm, directly checking the pathology of gastric cancer can reveal whether it is metastatic from ovarian cancer," Zhou Can offered a solution.